DESCRIPTION (adapted from the application) Mark A. Schnitzler, Ph. D., is a health economist with particular interest in renal transplantation. This K25 proposal is designed to enhance Dr. Schnitzler's knowledge of the practice of renal transplant medicine coupled with a research project examining the clinical and economic efficiency of cadaveric kidney allocation. The combination of these educational and research elements are designed to position Dr. Schnitzler to make important contributions to the study of renal transplantation as his career progresses. The educational portion of this project will use the resources of the nephrology and renal transplantation fellowships and the graduate curriculum of the Medical School at Washington University in St. Louis, Missouri to expose Dr. Schnitzler to the science and practice of renal transplant medicine. The program includes weekly observation of clinical practice during the first three years of the project and participation in the nephrology and renal transplant fellowship educational conference series for the full five years of the project. Graduate courses covering medical ethics and immunology will be taken throughout the five years of the project. The research program for this project examines the efficiency of various possible alternatives to the current cadaveric kidney allocation system. Little integrated study exists jointly examining the clinical and economic implications of organ allocation. There are four aims that cover: 1) the identification of alternative allocation systems; 2) the estimation of outcomes associated with allocation criteria; 3) estimation of the distributional characteristics of allocation systems; and 4) estimation of the relative potential clinical and economic results of alternative cadaveric kidney allocation systems.